Vitamin Infusion Consent

IV therapy is the administration of prescribed, vitamins and minerals into the body via a syringe or an intravenous (IV) infusion.

• Vitamins and minerals are essential for the cells to function properly. Vitamin infusions are the fastest, most efficient way for the body to receive hydration and micronutrients. All Vitamin Infusions are considered investigational, experimental, and are not considered standard of care.

• Improved sleep quality

• Reduced oxidative damage.

• Improved immune function.

• Improved antioxidant status.

• Overall feelings of well-being.

• Increased energy and mental clarity.

• Replacement of essential nutrients and correction of deficiencies.

Patients often express improvement in their condition after one treatment. However, depending condition, most patients require a course of infusions at scheduled intervals for best results.*

• Oral supplementation, diet, or lifestyle changes.*

• Active or recent viral or bacterial infection (coughs, colds, flu).*

• Autoimmune disorders.*

• Chemotherapy treatments.*

• Severe metabolic and systemic disorders.*

• Abnormal platelet function or blood disorders.*

• Chronic Liver Disease.*

• Anti-coagulation therapy (Coumadin, Warfarin, Plavix, Aspirin, Lovenox).*

• Underlying Sepsis.*

• Systemic use of corticosteroids within 2 weeks of procedure.*

• Allergies to product ingredients.*

• Pregnant or breastfeeding.*

• The solution is injected directly into the blood stream with a very fine needle. The procedure is described as painless and usually takes about 15 – 30 minutes to complete.*

• Pain, bleeding, bruising, infection, injury to nerve and/or muscle, puffiness/oedema, numbness, redness, swelling, haematoma, or other changes in sensation at injection sites.

• Flushing of the skin.

• Muscular spasms, weakness, or fatigue.

• Light-headedness or fainting.

• Mild diarrhoea, upset stomach, nausea.

• Severe reaction to medication, supplement or vitamin therapy; anaphylaxis, cardiac arrest or death.

• Volume overload, air embolism, infiltration.

• Minimal or no effect from the treatment.

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• Results are temporary, and several sessions may be needed for optimal results and further expenditure will be required.

• With all treatments the precise degree of improvement cannot be guaranteed. The outcome’s subjective nature also means dissatisfaction is a possible outcome regardless of effectiveness of treatment.

• Adjustments requiring more products will incur a charge.

• Initial treatment of side effects and complications is included in the cost of the procedure and therefore no refund is issued due to any of the above occurring.

• The procedure may be medically unnecessary, it may or may not mitigate, alleviate, or cure the condition for which it has been prescribed. The number of recommended treatments is an estimate. 

• I understand that I cannot have the procedure if I am pregnant, breastfeeding and/or under the age of 18 and confirm that I am not pregnant, breastfeeding nor under the age of 18 (without parental consent).

• I consent for appropriate portions of my body to be photographed or filmed before, during, and after the procedure for marketing, medical, scientific, or educational purposes, provided my identity is not revealed.

• I consent to the collection and storage of my personal information for my medical treatment and for it to be disclosed for my ongoing care or if required by law.